Carpal tunnel steroid injections or surgery?

A large clinical trial looked at carpal tunnel surgery vs. getting carpal tunnel steroid injections in the carpal tunnel area. The study looked at 163 wrists belonging to 101 patients (93 women,8 men) who had carpal tunnel syndrome (CTS).

All patients were having carpal tunnel symptoms, mainly nightly attacks of extreme tingling and burning of the hand and fingers for at least 3 months. Of the total wrists, 80 were randomly assigned to undergo carpal tunnel surgery (via a limited palmar incision).The remaining 83 were treated with local steroid injections. Patients in both groups were similar in age (early 50's).

[Also note that other carpal tunnel medicines besides carpal tunnel steroid injections can be used to treat CTS.]

All wrists were evaluated 14 days after the initial treatment.At that time 69 of the wrists that had been treated with steroids recieved a second local injection.

Researchers then assessed the symptoms of both groups at 3,6 and 12 months:

• At the 3 month mark 94% of the steroid injection group reported significant carpal tunnel pain relief,compared with 75% in the carpal tunnel surgery group.
• At the 6 month mark 85% of the steroid injection group still reported carpal tunnel relief compared to 76% in the carpal tunnel surgery group.
• At the 12 month mark 70% of the steroid injection group reported on-going carpal tunnel relief compared to 70% of the carpal tunnel surgery group.

Carpal tunnel steroid injections or surgery?

Dr. Domingo Ly-Pen says,"Our findings suggest that both local steroid injections and carpal tunnel surgery are highly effective in alleviating the symptoms of primary CTS at 12 months of follow-up. Nevertheless, local injection seems superior to surgery in the short-term."

Also as a note of intrest, more patients whose wrists were randomly assigned to the surgery group rejected the treatment (11 wrists) than those whose wrists were assigned to injection (1 wrist).

"This finding coincides with our daily clinical practice," Dr. Ly-Pen observes," in which patients usually prefer conservative treatments."

Carpal tunnel surgery may still be the best bet in severe cases of CTS in avoiding permanent nerve damage, but this study shows that local steroid injections can be an effective, affordable early treatment of carpal tunnel syndrome.

Also see carpal tunnel treatments with steroid pills.

Carpal tunnel exercises
Recovery from surgery
Non-surgical treatments
CTS wrist braces

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